HELLP-SYNDROME - CT EVALUATION

Patients with the HELLP syndrome (hemolysis, elevated liver enzymes, a nd low platelet count) require careful observation and expedient deliv ery. However, those who develop this syndrome peripartum do not always fulfill its diagnostic criteria before labor begins. We investigated the potential usefulness of liver and spleen CT evaluation in identify ing such patients. Seven patients with this syndrome were studied by C T scanning on postpartum days 0-3 and again 3-4 weeks after delivery. Although 3 patients with severe thrombocytopenia had a reduced liver-s pleen CT number ratio (<1.1) and subsequent normalization, the remaini ng 4 with less severe thrombocytopenia demonstrated no CT changes. Thu s, antepartum evaluation of liver and spleen by CT may not be sensitiv e enough to detect patients who develop HELLP syndrome during the peri partum period. Serial examination of platelet counts may be more usefu l than CT in detecting patients at risk for this peripartum syndrome.